MedImpact Healthcare Systems, Inc. · 20 hours ago
Clinical Administrative Pharmacist
United States
Full-time
Onsite
Mid, Senior Level
$129K/yr - $183K/yr
5+ years expMedImpact Healthcare Systems, Inc. is looking for extraordinary people to join their team. The Clinical Administrative Pharmacist will optimize clinical quality and cost-effectiveness of drug therapy for a state Medicaid agency, manage accounts, and collaborate with corporate resources to achieve financial goals.
Health CarePharmaceutical
No H1B
Responsibilities
Provides Support for the TennCare PA process, TennCare Appeals, TennCare Pharmacy Lock-In process, and assistance with the TennCare Pharmacy Audit process
Monitors contractual Service Level Agreements (SLAs) related to clinical services for managed account(s) and reports to leadership if risks are observed
Provides recommendations to assigned clients that align with the clients' goals of achieving lower net costs and high clinical quality. Strategic recommendations may include benefit design and Preferred Drug List (PDL) analysis and suggestions, provision of clinical drug information, utilization management criteria development, Pharmacy & Therapeutics (P&T) support and participation, recommendations for rational drug PDL positioning, online system edits and restrictions, ongoing clinical product evaluations, and recommendations regarding client pharmacy benefit utilization and performance trends
Offers clinical and Medicaid consultative services in accordance with contracted services. Acts as an integral part of designing, developing, and driving the clinical components of the assigned account team's strategic and financial goals. The CAE II focuses on using a variety of analytical tools and clinical resources to identify opportunities that simultaneously improve the plan sponsor's quality-focused and financial performance metrics
Identifies and promotes MedImpact's evidence-based interventions and communication programs to clients, providing documentation of recommendations for clinically appropriate and financially beneficial clinical initiatives (e.g., rebate enhancement, lower net cost, generic programs, QA programs)
Recommends clinically appropriate PDL changes, considering the lowest net cost after rebates, market shifts, and utilization
Coordinates clinical utilization analyses and presentations to clients, ensuring timely and accurate review of plan data according to policy and offering appropriate intervention recommendations
Coordinates the clinical support of Preferred Drug Lists during plan sponsor implementation
Participates in quarterly state P&T meetings as stipulated by client contracts
Qualification
Required
PharmD and 5+ years' experience or equivalent combination of education and experience, and 3 years of SME in respective areas; and must hold current Tennessee Board of Pharmacy licensure or complete license reciprocity prior to contract go-live date
Knowledge of Microsoft Office Suite and experience with at least one business intelligent tool (IBM Cognos or Tableau preferred)
Registered Pharmacist license in good standing and the ability to obtain licensure in specific state as necessary within 6 months
Familiar with First Databank and Medi-Span drug information
Analytical skills required to perform drug cost expenditure impact analysis
Exceptional communication skills and interpersonal skills to interface with clients and internal team members
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions
Ability to deal with problems involving a few concrete variables in standardized situations
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs
Ability to write routine reports and correspondence
Ability to speak effectively before groups of customers or employees of organization
Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community
Benefits
Medical / Dental / Vision / Wellness Programs
Paid Time Off / Company Paid Holidays
Incentive Compensation
401K with Company match
Life and Disability Insurance
Tuition Reimbursement
Employee Referral Bonus
Company
MedImpact Healthcare Systems, Inc.
MedImpact is the nation’s largest independent health solutions and pharmacy benefit company, serving commercial health plans, government programs, self insured/employer groups, and millions of consumers.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$1.38M2013-09-19Seed· $1.38M
Leadership Team
Frank Bunton
VP, CISO (Chief Information Security Officer)
Larry Biggs
Manager, Information Security
Recent News
Pharmacy Benefit Management Institute®
2025-09-26
2025-09-12
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